What is the best treatment for incompetent great or small saphenous veins?

Which is better, endovenous laser ablation or radio frequency ablation, for treatment of incompetent great or small saphenous veins?

This is a very common question I am asked by patients requiring treatment of symptomatic varicose veins as a result of an incompetent great saphenous vein or small saphenous vein. In reality both methods are more similar than different and both are very different from traditional stripping.

Traditional stripping technique for saphenous veins

The traditional stripping technique was done in a hospital operating room requiring general or regional anesthesia and incisions and was associated with significant postoperative pain and disability and recurrence.

Both endovenous laser ablation and radio frequency laser ablation are minimally invasive procedures performed without incisions. They can be performed in a doctors office with only local anesthesia by inserting a catheter into the vein using ultrasound guidance which is used to insure that the catheter and local anesthesia is placed in the correct position. They both then use thermal energy which is applied to the inside of the vein and destroys the vein using heat. With time the body will resorb the destroyed vein and it will disappear.

The difference between the two ablation techniques is the source of the heat. Laser is an anacroyn for Light Amplification by Stimulated Emission of Radiation, amplifies a narrow beam of electromagnetic energy to create heat. The laser is used in different wavelengths which are absorbed differently by hemoglobin and water. The radio frequency device works using thermocoagulation which uses electrical energy to create heat.

The advantage of radio frequency technique for saphenous veins

The main advantage of the radio frequency technique compared to the laser according to reports has been less postoperative pain and bruising although slightly lower long term closure rates. However, with newer laser technology and longer wavelengths the pain profiles and leg bruising are now equivalent.From a patient standpoint both techniques are pretty much identical. Patients should more concerned with the credentials and experience of the operator rather than whether the physician uses laser or radio frequency to ablate the vein.

Westchester, New York Spider Saphenous Vein Treatment

Let us help you decide the best treatment for your Saphenous Veins and ask us for Saphenous Vein treatment cost estimates, call our Westchester, New York office at 888-265-9597.

About the Author

Arlen Fleisher, MD is a Diplomate of the American Board of Phlebology, the branch of medicine that deals with the veins. With nearly 30 years of medical experience, Dr. Fleisher gives his patients a depth of understanding that is difficult to match. Read More…